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NPI Code Detail

MEDICARE: MRS. KRISTEN M GILLEO FNP

MEDICARE: MRS. KRISTEN M GILLEO FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner715MN
2363LF0000XFamily Nurse PractitionerR-162672-6MN
3363LF0000XFamily Nurse Practitioner715MN

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00348432OTHERMNRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1598766677
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KRISTEN M GILLEO FNP
Provider Business Mailing Address
First Line : 1880 N FRONTAGE RD
Second Line :
City : HASTINGS
State : MN
Zip : 55033-2687
Country : US
Telephone Number : 651-436-1800
Fax Number :
Provider Business Practice Location Address
First Line : 1880 N FRONTAGE RD
Second Line :
City : HASTINGS
State : MN
Zip : 55033-2687
Country : US
Telephone Number : 651-438-1880
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/10/2005
Last Update Date : 03/11/2021

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